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Published in: Pediatric Nephrology 6/2015

01-06-2015 | Original Article

Interdialytic weight gain in oligoanuric children and adolescents on chronic hemodialysis

Authors: Fabio Paglialonga, Silvia Consolo, Maria Albina Galli, Sara Testa, Alberto Edefonti

Published in: Pediatric Nephrology | Issue 6/2015

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Abstract

Background

Little is known about the clinical impact of interdialytic weight gain (IDWG) on oligoanuric children undergoing chronic hemodialysis (HD).

Methods

We retrospectively assessed IDWG, left ventricular mass index (LVMI) and its changes (ΔLVMI), pre-HD systolic and diastolic blood pressure (DBP), residual urine output, Kt/V, the frequency of intradialytic symptoms, normalized protein catabolic rate, and the 3-month change in the dry weight of 16 hemodialyzed oligoanuric patients with a median age of 14.8 years (range 5.0–17.9).

Results

There was a significant correlation between IDWG and median LVMI (r 0.55, p = 0.026), which was 27.3 g/m2.7 (22.5–37.6) in the patients with a median IDWG of <4 %, and 44.3 g/m2.7 (28.2–68.7) in those with a median IDWG of >4 % (p = 0.003). None of the four patients with an IDWG of <4 % showed left ventricular hypertrophy, compared with 10 of the 12 patients (83.3 %) with an IDWG of >4 % (p = 0.003); the former also had a better median ΔLVMI (−33.5 % vs −13.0 %; p = 0.02) and a lower median DBP sds (0.24 vs 1.72, p = 0.04).

Conclusions

There is a significant correlation between IDWG and LVMI in pediatric oligoanuric patients on chronic HD: those with an IDWG of >4 % are at a higher risk of left ventricular hypertrophy.
Literature
1.
go back to reference Groothoff JW, Gruppen MP, Offringa M, Hutten J, Lilien MR, Van De Kar NJ, Wolff ED, Davin JC, Heymans HS (2002) Mortality and causes of death of end-stage renal disease in children: a Dutch cohort study. Kidney Int 61:621–629CrossRefPubMed Groothoff JW, Gruppen MP, Offringa M, Hutten J, Lilien MR, Van De Kar NJ, Wolff ED, Davin JC, Heymans HS (2002) Mortality and causes of death of end-stage renal disease in children: a Dutch cohort study. Kidney Int 61:621–629CrossRefPubMed
2.
go back to reference Glassock RJ, Pecoits-Filho R, Barberato SH (2009) Left ventricular mass in chronic kidney disease and ESRD. Clin J Am Soc Nephrol 4(Suppl 1):S79–S91CrossRefPubMed Glassock RJ, Pecoits-Filho R, Barberato SH (2009) Left ventricular mass in chronic kidney disease and ESRD. Clin J Am Soc Nephrol 4(Suppl 1):S79–S91CrossRefPubMed
3.
go back to reference Drukker A, Urbach J, Glaser J (1981) Hypertrophic cardiomyopathy in children with end-stage renal disease and hypertension. Proc Eur Dial Transplant Assoc 18:542–547PubMed Drukker A, Urbach J, Glaser J (1981) Hypertrophic cardiomyopathy in children with end-stage renal disease and hypertension. Proc Eur Dial Transplant Assoc 18:542–547PubMed
4.
go back to reference Borzych D, Bakkaloglu SA, Zaritsky J, Suarez A, Wong W, Ranchin B, Qi C, Szabo AJ, Coccia PA, Harambat J, Mitu F, Warady BA, Schaefer F, International Pediatric Peritoneal Dialysis Network (2011) Defining left ventricular hypertrophy in children on peritoneal dialysis. Clin J Am Soc Nephrol 6:1934–1943CrossRefPubMedCentralPubMed Borzych D, Bakkaloglu SA, Zaritsky J, Suarez A, Wong W, Ranchin B, Qi C, Szabo AJ, Coccia PA, Harambat J, Mitu F, Warady BA, Schaefer F, International Pediatric Peritoneal Dialysis Network (2011) Defining left ventricular hypertrophy in children on peritoneal dialysis. Clin J Am Soc Nephrol 6:1934–1943CrossRefPubMedCentralPubMed
5.
go back to reference Bakkaloglu SA, Borzych D, Soo Ha I, Serdaroglu E, Büscher R, Salas P, Patel H, Drozdz D, Vondrak K, Watanabe A, Villagra J, Yavascan O, Valenzuela M, Gipson D, Ng KH, Warady BA, Schaefer F, International Pediatric Peritoneal Dialysis Network (2011) Cardiac geometry in children receiving chronic peritoneal dialysis: findings from the international pediatric peritoneal dialysis network (IPPN) registry. Clin J Am Soc Nephrol 6:1926–1933CrossRefPubMedCentralPubMed Bakkaloglu SA, Borzych D, Soo Ha I, Serdaroglu E, Büscher R, Salas P, Patel H, Drozdz D, Vondrak K, Watanabe A, Villagra J, Yavascan O, Valenzuela M, Gipson D, Ng KH, Warady BA, Schaefer F, International Pediatric Peritoneal Dialysis Network (2011) Cardiac geometry in children receiving chronic peritoneal dialysis: findings from the international pediatric peritoneal dialysis network (IPPN) registry. Clin J Am Soc Nephrol 6:1926–1933CrossRefPubMedCentralPubMed
6.
go back to reference Mitsnefes MM, Daniels SR, Schwartz SM, Meyer RA, Khoury P, Strife CF (2000) Severe left ventricular hypertrophy in pediatric dialysis: prevalence and predictors. Pediatr Nephrol 14:898–902CrossRefPubMed Mitsnefes MM, Daniels SR, Schwartz SM, Meyer RA, Khoury P, Strife CF (2000) Severe left ventricular hypertrophy in pediatric dialysis: prevalence and predictors. Pediatr Nephrol 14:898–902CrossRefPubMed
7.
go back to reference Mitsnefes MM, Daniels SR, Schwartz SM, Khoury P, Strife CF (2001) Changes in left ventricular mass in children and adolescents during chronic dialysis. Pediatr Nephrol 16:318–323CrossRefPubMed Mitsnefes MM, Daniels SR, Schwartz SM, Khoury P, Strife CF (2001) Changes in left ventricular mass in children and adolescents during chronic dialysis. Pediatr Nephrol 16:318–323CrossRefPubMed
8.
go back to reference Chavers BM, Solid CA, Sinaiko A, Daniels FX, Chen SC, Collins AJ, Frankenfield DL, Herzog CA (2011) Diagnosis of cardiac disease in pediatric end-stage renal disease. Nephrol Dial Transplant 26:1640–1645CrossRefPubMedCentralPubMed Chavers BM, Solid CA, Sinaiko A, Daniels FX, Chen SC, Collins AJ, Frankenfield DL, Herzog CA (2011) Diagnosis of cardiac disease in pediatric end-stage renal disease. Nephrol Dial Transplant 26:1640–1645CrossRefPubMedCentralPubMed
9.
go back to reference Sozeri B, Mir S, Kara OD, Levent E (2010) When does the cardiovascular disease appear in patients with chronic kidney disease? Pediatr Cardiol 31:821–828CrossRefPubMed Sozeri B, Mir S, Kara OD, Levent E (2010) When does the cardiovascular disease appear in patients with chronic kidney disease? Pediatr Cardiol 31:821–828CrossRefPubMed
10.
go back to reference Bakkaloglu SA, Saygily A, Sever L, Noyan A, Akman S, Ekim M, Aksu N, Doganay B, Yildiz N, Duzova A, Soylu A, Alpay H, Sonmez F, Civilibal M, Erdem S, Kardelen F (2009) Assessment of cardiovascular risk in paediatric peritoneal dialysis patients: a Turkish Pediatric Peritoneal Dialysis Study Group (TUPEPD) report. Nephrol Dial Transplant 24:3525–3532CrossRefPubMed Bakkaloglu SA, Saygily A, Sever L, Noyan A, Akman S, Ekim M, Aksu N, Doganay B, Yildiz N, Duzova A, Soylu A, Alpay H, Sonmez F, Civilibal M, Erdem S, Kardelen F (2009) Assessment of cardiovascular risk in paediatric peritoneal dialysis patients: a Turkish Pediatric Peritoneal Dialysis Study Group (TUPEPD) report. Nephrol Dial Transplant 24:3525–3532CrossRefPubMed
11.
go back to reference Civilibal M, Caliskan S, Oflaz H, Sever L, Candan C, Canpolat N, Kasapcopur O, Bugra Z, Arisoy N (2007) Traditional and “new” cardiovascular risk markers and factors in pediatric dialysis patients. Pediatr Nephrol 22:1021–1029CrossRefPubMed Civilibal M, Caliskan S, Oflaz H, Sever L, Candan C, Canpolat N, Kasapcopur O, Bugra Z, Arisoy N (2007) Traditional and “new” cardiovascular risk markers and factors in pediatric dialysis patients. Pediatr Nephrol 22:1021–1029CrossRefPubMed
12.
go back to reference Koc Y, Unsal A, Kayabasi H, Oztekin E, Sakaci T, Ahbap E, Yilmaz M, Akgun AO (2011) Impact of volume status on blood pressure and left ventricle structure in patients undergoing chronic hemodialysis. Ren Fail 33:377–381CrossRefPubMed Koc Y, Unsal A, Kayabasi H, Oztekin E, Sakaci T, Ahbap E, Yilmaz M, Akgun AO (2011) Impact of volume status on blood pressure and left ventricle structure in patients undergoing chronic hemodialysis. Ren Fail 33:377–381CrossRefPubMed
14.
go back to reference Goldfarb-Rumyantzev AS, Chelamcharla M, Bray BE, Leypoldt JK, Lavasani I, Nelson N, Lavasani T, Baird B, Cheung AK (2009) Volume indicators and left ventricular mass during aggressive volume management in patients on thrice-weekly hemodialysis. Nephron Clin Pract 113:c270–c280CrossRefPubMed Goldfarb-Rumyantzev AS, Chelamcharla M, Bray BE, Leypoldt JK, Lavasani I, Nelson N, Lavasani T, Baird B, Cheung AK (2009) Volume indicators and left ventricular mass during aggressive volume management in patients on thrice-weekly hemodialysis. Nephron Clin Pract 113:c270–c280CrossRefPubMed
15.
go back to reference Dheu C, Terzic J, Menouer S, Fischbach M (2009) Importance of the curve shape for interpretation of blood volume monitor changes during haemodiafiltration. Pediatr Nephrol 24:1419–1423CrossRefPubMed Dheu C, Terzic J, Menouer S, Fischbach M (2009) Importance of the curve shape for interpretation of blood volume monitor changes during haemodiafiltration. Pediatr Nephrol 24:1419–1423CrossRefPubMed
16.
go back to reference Candan C, Sever L, Civilibal M, Caliskan S, Arisoy N (2009) Blood volume monitoring to adjust dry weight in hypertensive pediatric hemodialysis patients. Pediatr Nephrol 24:581–587CrossRefPubMed Candan C, Sever L, Civilibal M, Caliskan S, Arisoy N (2009) Blood volume monitoring to adjust dry weight in hypertensive pediatric hemodialysis patients. Pediatr Nephrol 24:581–587CrossRefPubMed
17.
go back to reference Dietel T, Filler G, Grenda R, Wolfish N (2000) Bioimpedance and inferior vena cava diameter for assessment of dialysis dry weight. Pediatr Nephrol 14:903–907CrossRefPubMed Dietel T, Filler G, Grenda R, Wolfish N (2000) Bioimpedance and inferior vena cava diameter for assessment of dialysis dry weight. Pediatr Nephrol 14:903–907CrossRefPubMed
18.
go back to reference Patel HP, Goldstein SL, Mahan JD, Smith B, Fried CB, Currier H, Flynn JT (2007) A standard, noninvasive monitoring of hematocrit algorithm improves blood pressure control in pediatric hemodialysis patients. Clin J Am Soc Nephrol 2:252–257CrossRefPubMed Patel HP, Goldstein SL, Mahan JD, Smith B, Fried CB, Currier H, Flynn JT (2007) A standard, noninvasive monitoring of hematocrit algorithm improves blood pressure control in pediatric hemodialysis patients. Clin J Am Soc Nephrol 2:252–257CrossRefPubMed
19.
go back to reference Brooks ER, Fatallah-Shaykh SA, Langman CB, Wolf KM, Price HE (2008) Bioelectric impedance predicts total body water, blood pressure, and heart rate during hemodialysis in children and adolescents. J Ren Nutr 18:304–311CrossRefPubMed Brooks ER, Fatallah-Shaykh SA, Langman CB, Wolf KM, Price HE (2008) Bioelectric impedance predicts total body water, blood pressure, and heart rate during hemodialysis in children and adolescents. J Ren Nutr 18:304–311CrossRefPubMed
20.
go back to reference Fenech M, Maasrani M, Jaffrin MY (2001) Fluid volumes determination by impedance spectroscopy and hematocrit monitoring: application to pediatric hemodialysis. Artif Organs 25:89–98CrossRefPubMed Fenech M, Maasrani M, Jaffrin MY (2001) Fluid volumes determination by impedance spectroscopy and hematocrit monitoring: application to pediatric hemodialysis. Artif Organs 25:89–98CrossRefPubMed
21.
go back to reference Paglialonga F, Ardissino G, Galli MA, Scarfia RV, Testa S, Edefonti A (2012) Bioimpedance analysis and cardiovascular status in pediatric patients on chronic hemodialysis. Hemodial Int 16:S20–S25CrossRefPubMed Paglialonga F, Ardissino G, Galli MA, Scarfia RV, Testa S, Edefonti A (2012) Bioimpedance analysis and cardiovascular status in pediatric patients on chronic hemodialysis. Hemodial Int 16:S20–S25CrossRefPubMed
22.
go back to reference Hothi DK, Rees L, Marek J, Burton J, McIntyre CW (2009) Pediatric myocardial stunning underscores the cardiac toxicity of conventional hemodialysis treatments. Clin J Am Soc Nephrol 4:790–797CrossRefPubMedCentralPubMed Hothi DK, Rees L, Marek J, Burton J, McIntyre CW (2009) Pediatric myocardial stunning underscores the cardiac toxicity of conventional hemodialysis treatments. Clin J Am Soc Nephrol 4:790–797CrossRefPubMedCentralPubMed
23.
go back to reference Movilli E, Gaggia P, Zubani R, Camerini C, Vizzardi V, Parrinello G, Savoldi S, Fischer MS, Londrino F, Cancarini G (2007) Association between high ultrafiltration rates and mortality in uraemic patients on regular haemodialysis. A 5-year prospective observational multicentre study. Nephrol Dial Transplant 22:3547–3552CrossRefPubMed Movilli E, Gaggia P, Zubani R, Camerini C, Vizzardi V, Parrinello G, Savoldi S, Fischer MS, Londrino F, Cancarini G (2007) Association between high ultrafiltration rates and mortality in uraemic patients on regular haemodialysis. A 5-year prospective observational multicentre study. Nephrol Dial Transplant 22:3547–3552CrossRefPubMed
24.
go back to reference Rajan VR, Mitch WE (2008) Muscle wasting in chronic kidney disease: the role of the ubiquitin proteasome system and its clinical impact. Pediatr Nephrol 23:527–535CrossRefPubMedCentralPubMed Rajan VR, Mitch WE (2008) Muscle wasting in chronic kidney disease: the role of the ubiquitin proteasome system and its clinical impact. Pediatr Nephrol 23:527–535CrossRefPubMedCentralPubMed
25.
go back to reference Devereux RB, Alonso DR, Lutas EM, Gottlieb GJ, Campo E, Sachs I, Reichek N (1986) Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am J Cardiol 57:450–458CrossRefPubMed Devereux RB, Alonso DR, Lutas EM, Gottlieb GJ, Campo E, Sachs I, Reichek N (1986) Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am J Cardiol 57:450–458CrossRefPubMed
26.
go back to reference Daniels SR, Kimball TR, Morrison JA, Khoury P, Meyers RA (1995) Indexing left ventricular mass to account for differences in body size in children and adolescents without cardiovascular disease. Am J Cardiol 76:699–701CrossRefPubMed Daniels SR, Kimball TR, Morrison JA, Khoury P, Meyers RA (1995) Indexing left ventricular mass to account for differences in body size in children and adolescents without cardiovascular disease. Am J Cardiol 76:699–701CrossRefPubMed
27.
go back to reference Katsoufis C, Seeherunvong W, Sasaki N, Abitbol CL, Chandar J, Freundlich M, Zilleruelo GE (2014) Forty-four-hour interdialytic ambulatory blood pressure monitoring and cardiovascular risk in pediatric hemodialysis patients. Clin Kidney J 7:33–39CrossRefPubMedCentralPubMed Katsoufis C, Seeherunvong W, Sasaki N, Abitbol CL, Chandar J, Freundlich M, Zilleruelo GE (2014) Forty-four-hour interdialytic ambulatory blood pressure monitoring and cardiovascular risk in pediatric hemodialysis patients. Clin Kidney J 7:33–39CrossRefPubMedCentralPubMed
28.
go back to reference Zaloszyc A, Schaefer B, Schaefer F, Krid S, Salomon R, Niaudet P, Schmitt CP, Fischbach M (2013) Hydration measurement by bioimpedance spectroscopy and blood pressure management in children on hemodialysis. Pediatr Nephrol 28:2169–2177CrossRefPubMed Zaloszyc A, Schaefer B, Schaefer F, Krid S, Salomon R, Niaudet P, Schmitt CP, Fischbach M (2013) Hydration measurement by bioimpedance spectroscopy and blood pressure management in children on hemodialysis. Pediatr Nephrol 28:2169–2177CrossRefPubMed
29.
go back to reference Fischbach M, Dheu C, Seuge L, Menouer S, Terzic J (2008) In-center daily on-line hemodiafiltration: a 4-year experience in children. Clin Nephrol 69:279–284CrossRefPubMed Fischbach M, Dheu C, Seuge L, Menouer S, Terzic J (2008) In-center daily on-line hemodiafiltration: a 4-year experience in children. Clin Nephrol 69:279–284CrossRefPubMed
30.
go back to reference Fischbach M, Terzic J, Menouer S, Dheu C, Seuge L, Zalosczic A (2010) Daily on line haemodiafiltration promotes catch-up growth in children on chronic dialysis. Nephrol Dial Transplant 25:867–873CrossRefPubMed Fischbach M, Terzic J, Menouer S, Dheu C, Seuge L, Zalosczic A (2010) Daily on line haemodiafiltration promotes catch-up growth in children on chronic dialysis. Nephrol Dial Transplant 25:867–873CrossRefPubMed
31.
go back to reference Fischbach M, Terzic J, Laugel V, Dheu C, Menouer S, Helms P, Livolsi A (2004) Daily on-line haemodiafiltration: a pilot trial in children. Nephrol Dial Transplant 19:2360–2367CrossRefPubMed Fischbach M, Terzic J, Laugel V, Dheu C, Menouer S, Helms P, Livolsi A (2004) Daily on-line haemodiafiltration: a pilot trial in children. Nephrol Dial Transplant 19:2360–2367CrossRefPubMed
32.
go back to reference Goldstein SL, Silverstein DM, Leung JC, Feig DI, Soletsky B, Knight C, Warady BA (2008) Frequent hemodialysis with NxStage system in pediatric patients receiving maintenance hemodialysis. Pediatr Nephrol 23:129–135CrossRefPubMed Goldstein SL, Silverstein DM, Leung JC, Feig DI, Soletsky B, Knight C, Warady BA (2008) Frequent hemodialysis with NxStage system in pediatric patients receiving maintenance hemodialysis. Pediatr Nephrol 23:129–135CrossRefPubMed
33.
go back to reference Warady BA, Fischbach M, Geary D, Goldstein SL (2007) Frequent hemodialysis in children. Adv Chron Kidney Dis 14:297–303CrossRef Warady BA, Fischbach M, Geary D, Goldstein SL (2007) Frequent hemodialysis in children. Adv Chron Kidney Dis 14:297–303CrossRef
34.
go back to reference Fischbach M, Fothergill H, Zaloszyc A, Menouer S, Terzic J (2011) Intensified daily dialysis: the best chronic dialysis option for children? Semin Dial 24:640–644CrossRefPubMed Fischbach M, Fothergill H, Zaloszyc A, Menouer S, Terzic J (2011) Intensified daily dialysis: the best chronic dialysis option for children? Semin Dial 24:640–644CrossRefPubMed
35.
go back to reference Müller D, Zimmering M, Chan CT, McFarlane PA, Pierratos A, Querfeld U (2008) Intensified hemodialysis regimens: neglected treatment options for children and adolescents. Pediatr Nephrol 23:1729–1736CrossRefPubMed Müller D, Zimmering M, Chan CT, McFarlane PA, Pierratos A, Querfeld U (2008) Intensified hemodialysis regimens: neglected treatment options for children and adolescents. Pediatr Nephrol 23:1729–1736CrossRefPubMed
Metadata
Title
Interdialytic weight gain in oligoanuric children and adolescents on chronic hemodialysis
Authors
Fabio Paglialonga
Silvia Consolo
Maria Albina Galli
Sara Testa
Alberto Edefonti
Publication date
01-06-2015
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Nephrology / Issue 6/2015
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-014-3005-2

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